Saturday, 31 December 2016 10:59

MULTIPLE SCLEROSIS: THE FACTS

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1. Multiple sclerosis is an autoimmune disease in which the body’s own white blood cells, which normally protect the body from infections and cancers, attack and damage nerve cells in the central nervous system (CNS).

2. The immune cells destroy the fatty sheath that surrounds and insulates the nerve cells in the brain and spinal cord (CNS), interrupting efficient communication between cells and resulting in progressive decline of neurological and cognitive function.

3. Symptoms are variable depending on the location of the damage in the central nervous system. Initial symptoms may include double vision, blurred vision or sudden vision loss; fatigue; difficulties with balance and walking; spasticity; bladder and/or bowel dysfunction (e.g., incontinence); pain and sexual dysfunction. Exercise, stress and heat may make symptoms worse.

4. Most people with MS (90%) have a ‘relapsing-remitting’ form characterised by periods of symptoms that resolve spontaneously within 4 to 12 weeks. These are followed by a period of remission lasting months to years during which no new symptoms develop. However, with time (years), if the MS remains untreated, it usually will progress to a form where the symptoms do not resolve and slowly become worse.

5. The exact cause of MS is unknown. Genetic factors contribute to MS risk and people with a first degree relative are approximately 9 times more likely to develop MS than those without MS in the family. Other factors that are thought to play a role include sunlight exposure, vitamin D deficiency, smoking and infection with the Epstein Barr virus (EBV).

6. Second only to trauma, MS is the second most common cause of neurological disability in young adults.

7. The exact number of people with MS in South Africa is unknown, but it is estimated that there are 2.5 million people affected worldwide.1 The number of people who are developing MS every year is increasing, especially among women.

8. MS is most common among people of Northern Europe and is uncommon in people of African descent.

9. Most people with MS are 20 to 50 years of age; 75% are women.

10. The diagnosis of MS is made by identifying recurring or progressive symptoms and by demonstrating lesions in the CNS with radiological imaging (e.g. magnetic resonance imaging, MRI).

11. Goals of treatment include treating symptoms, preventing progression, reducing the number of relapses and helping people with MS cope with the psychological burden of the disease (e.g. depression and worry about how MS will affect life).

12. With early diagnosis and treatment, people with MS can live a full, successful and satisfying life, with a normal life-span and without physical disability.

References

1. Browning V, Joseph M, Sedrack M. Multiple sclerosis: A comprehensive review for the physician assistant. JAAPA 2012; 25(8): 24-29.

2. Kamm CP, Uitdehaag BM, Polman CH. Multiple sclerosis: Current knowledge and future outlook. Eur Neurol 2014; 72:132-141.

3. Goodin DS. The causal cascade to multiple sclerosis: a model for MS pathogenesis. PLoS ONE 2009; 4(2): e4565. doi:10.1371/journal.pone.0004565

4. American Academy of Neurology (2012). Understanding multiple sclerosis. https://patients.aan.com/globals/axon/assets/10022.pdf. Accessed 24 October 2016.

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